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A Quick Guide for Rural Health Clinics
Applying for National Health Service Corps (NHSC) Site Approval
Approximately 3,800 Rural Health Clinics (RHCs) nationwide provide access to primary care services in rural
areas as certified by Centers for Medicare/Medicaid Services (CMS). Currently, we estimate less than one third
of RHCs are NHSC‐approved Sites. Recruitment and retention of clinicians in rural communities is no easy task.
Since 1970 the NHSC, through Scholarship and Loan Repayment Programs, has helped clinical sites attract and
retain medical, dental and mental health providers who are dedicated to working in underserved communities.
Many RHCs may not know about their ability to use the NHSC as a tool in their recruitment and retention
strategy. NHSC has provided the following guideline to educate and assist RHCs in applying for NHSC Site
Approval as well as providing information on how to post vacancies for clinical openings.
Did you know?
1. CMS Certified RHCs are offered an Automatic Health Professional Shortage Area (HPSA) designation.
“The Health Care Safety Net Amendments of 2002 provided for automatic facility HPSA status for all RHCs that meet the
requirement of providing access to care regardless of ability to pay.” Read more:
http://bhpr.hrsa.gov/shortage/autoscore.htm. Call (301) 594‐0816 for more information.
2. After attaining HPSA designation, meeting eligibility requirements for NHSC Site‐approval is relatively
simple. Facilities may be eligible if it:
Is located in a HPSA
Provides at least one of the following services: primary care, mental and behavioral health, or dental services
Provides services on a discount‐fee schedule
Accepts Medicare, Medicaid, and Children’s Health Insurance Plan
Maintains full‐time hours (40 hours; 36 of which are clinic hours)
Follows sound fiscal management.
Read more: www.nhsc.hrsa.gov/communities
3. By joining the NHSC by becoming an approved site, you can better attract and retain primary care
clinicians. Membership in the NHSC provides you:
Tools to help you recruit and retain clinicians. (About 80 percent of NHSC clinicians continue to work in a HPSA
beyond their initial commitments, 70 percent stay at least five years and about 50 percent make caring for
underserved people their career.)
An added benefit to clinical staff at no additional cost.
Access to our national recruitment database where you can post clinician vacancies http://nhscjobs.hrsa.gov
Ability to recruit midlevel providers, such as Physician Assistants and Nurse Practitioners, who actively use the Job
Opportunities List and are eligible for loan repayment opportunities.
Linkages with academic institutions and other organizations to support your recruitment efforts.
An RHC’s Quick Guide to Applying for NHSC Site Approval
Created by: Health Resources and Services Administration,
Bureau of Clinician Recruitment and Service, Recruitment and Retention Branch
May 2010
Interested in Applying to the NHSC?
1. Before contacting HRSA, certify that your site is recognized as a Rural Health Clinic by CMS
a. Have you completed the 8A55?
http://www.cms.hhs.gov/MedicareProviderSupEnroll/02_EnrollmentApplications.asp
b. Does your facility appear on this list? This is the list the HRSA uses to verify that a site is eligible for an Automatic
HPSA Designation. http://www.cms.hhs.gov/MLNProducts/downloads/rhclistbyprovidername.pdf
If you have documentation from CMS that shows you are certified as an RHC, but are not on this list, you can
provide a copy of the documentation with your NHSC R&R Application.
2. Confirm that you meet the basic eligibility criteria as outlined by NHSC
a. All NHSC eligibility requirements can be found here: www.nhsc.hrsa.gov/communities. A few specific resources
are listed below:
b. Is your site located in a HPSA? Or is has it been given an automatic HPSA?
Check: http://hpsafind.hrsa.gov/ for your State and County to confirm. The HPSA score will be displayed as
well. If there is no score or a “0” for the RHC HPSA score, you can submit a form to the Office of Shortage
Designation at HRSA. See attached: “Certificate of Eligibility for Automatic HPSA Designation for RHCs.pdf”
c. Does your site have a sliding fee scale in place? If not, here is a resource to help you create one.
http://www.nhsc.hrsa.gov/communities/discountedfee.pdf
d. Questions regarding your Site’s eligibility should be directed to the NHSC Recruitment Training and Support Center
at 1‐877‐313‐1823.
3. Contact your State Primary Care Office
a. State Primary Care Offices (PCO) are a resource in helping clinical facilities apply for NHSC site approval. Your State
contact must be notified of you intention to apply for NHSC site approval.
http://bhpr.hrsa.gov/Shortage/pcos.htm
4. Complete the 10‐page NHSC Recruitment and Retention Assistance Application (R&R Application)
http://nhsc.hrsa.gov/applications/rraa.asp
a. Solo or Group Practices may need to complete the Private Practice Option (PPO) application in addition to the
R&R. http://www.nhsc.hrsa.gov/loanrepayment/ppo_app.pdf
5. Compile and mail in the required documentation with your application
a. The verification process takes approximately 6‐8 weeks. You may contact the Recruitment Training Support Center
at 1‐877‐313‐1823 to check on the status of your application.
6. Submit a renewal application every three years to maintain your NHSC approval status
Attachments
1. Certificate of Eligibility for Automatic HPSA
Designation for RHCs.pdf
2. NARCH TA Call Slides.May 2010.ppt
An RHC’s Quick Guide to Applying for NHSC Site Approval
Created by: Health Resources and Services Administration,
Bureau of Clinician Recruitment and Service, Recruitment and Retention Branch
May 2010